Testosterone Topical

• Increased muscle mass and strength with improved body composition
• Improved sexual function and desire
• Enhanced mood and overall quality of life
• Improved bone mineral density
• Increased energy levels
• Reduction in symptoms of depression
• Improved cognitive function
• Potential improvement in glucose homeostasis in males

• Male vs female hormone replacement therapy (HRT) strengths will vary
• Regular blood tests are necessary to monitor testosterone levels, blood counts, liver function, and PSA in men

Testosterone is a Schedule III controlled substance and requires a valid DEA number from the prescribing provider for fulfillment.

Contraindications

• Known allergy to testosterone or any component of the formulation
• Men with breast or prostate cancer
• Individuals with serious heart, kidney, or liver disease

Potential Side Effects

• Increased blood pressure
• Acne
• Weight gain
• Decreased sperm count
• Blood clots (leg swelling, pain, redness)
• Liver toxicity (jaundice, dark urine, abdominal pain)
• May cause skin irritation at the application site for creams
• Increased red blood cells (polycythemia)
• Overuse can lead to excessive testosterone levels potentially causing mood changes, hoarsening of voice, hirsutism and other hormonal imbalances

Warnings

• Potential risks associated with testosterone replacement therapy include stimulation of growth of prostate cancer and breast cancer, worsening symptoms of benign prostatic hyperplasia (BPH), altered blood glucose control, increased bleeding risk, and exacerbated sleep apnea.
• Exogenous testosterone may suppress intratesticular testosterone via negative feedback loops adversely affecting sperm production and fertility in men and contribute to testicular atrophy

Precautions

• Wear clothing to cover the application site once the cream has been fully absorbed to help prevent accidental transfer to others, including children, adults, or pets. Avoid direct contact between the application area and others. In the event of accidental exposure, wash the affected area thoroughly with soap and water as soon as possible.

Testosterone cream delivers bioidentical testosterone transdermally (through skin absorption), allowing it to enter the bloodstream directly and bypass first-pass metabolism in the liver. This delivery method helps mimic the body’s natural testosterone release.

Testosterone is a sex hormone with both androgenic (male characteristic expression) and anabolic effects. It plays an essential role in both men and women, working in conjunction with other sex hormones. Among its many potential functions are signaling red blood cell production, regulating puberty and fertility, increasing muscle and bone strength, enhancing libido, and supporting energy and overall vitality.

Q. How does cream dosing compare to oral or injection routes of administration?

A. Bioidentical testosterone administered through the skin bypasses gastrointestinal and hepatic metabolism, thereby reducing the risk of side effects compared to oral formulations. Transdermal delivery may also offer safety advantages over injectable forms, as properly dosed topical testosterone is less likely to produce supraphysiologic serum levels. Notably, the TRAVERSE trial found no increased cardiovascular risk with transdermal testosterone compared to placebo.¹

However, testosterone cream may present dosing challenges, as factors such as daily adherence, skin hydration, and application technique can contribute to variability in achieving consistent serum levels.

Q. What do you mean that the medication is "bioidentical?"

A. "Bioidentical' means it is the same exact molecule as produced naturally by the body. In contrast, methyltestosterone is a synthetic, and the body may metabolize it differently and may have physiological effects that diverge from naturally produced testosterone. Bioidentical hormones provide some reassurance that the medication behaves in a normal physiologic fashion and potential unwanted effects are minimized.

Q. How does Strive's testosterone cream compare to commercial testosterone gels?

Strive's testosterone creams are compounded using pharmaceutical-grade ingredients in bases specifically optimized for hormone delivery. Unlike commercial gels, which are typically formulated for male dosing, compounded creams can be customized to meet the individualized needs of patients, especially women, who often require significantly lower doses. This tailored approach helps reduce the risk of dosing errors and improves therapeutic precision.

Q. Can women use testosterone?

A. Yes. Even though testosterone is often viewed as a male hormone, it is critical in both men and women, albeit in different amounts. With levels in women generally one-tenth of that in men, extra care must be taken when dosing in women. Though testosterone is sometimes given to menopausal women along with progesterone and estrogen, a decline in levels appears to be age related throughout the adult years rather than at onset of perimenopause. Low testosterone in women may manifest as symptoms of declining body composition, frailty, low libido, depression or anxiety disorders, low energy levels, pain with intercourse, and an increased risk of Urinary Tract Infections (UTI). Despite this, there is no FDA approved testosterone product for women! Multiple Strive testosterone medications can fulfill the unique dosing requirements of testosterone in women.

Q: How long does it take to notice results?

A: Some patients may notice benefit within a few weeks, but it might take several months for the full benefits to be observed.

Q: Can I stop using it abruptly?

A. Consult your healthcare provider before stopping therapy, as abrupt discontinuation may affect hormone levels.

Q: What if I miss a dose?

A. Apply the missed dose as soon as you remember unless it's almost time for your next dose.

1. Lincoff AM, Bhasin S, Flevaris P, Mitchell LM, Basaria S, Boden WE, Cunningham GR, Granger CB, Khera M, Thompson IM Jr, Wang Q, Wolski K, Davey D, Kalahasti V, Khan N, Miller MG, Snabes MC, Chan A, Dubcenco E, Li X, Yi T, Huang B, Pencina KM, Travison TG, Nissen SE; TRAVERSE Study Investigators. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023 Jul 13;389(2):107-117. doi: 10.1056/NEJMoa2215025. Epub 2023 Jun 16. PMID: 37326322.